POS0046-HPR THE EFFECT OF MEDITATION, MINDFULNESS, AND YOGA IN PATIENTS WITH RHEUMATOID ARTHRITIS
Authors: L. Slagter, K. Demyttenaere, D. De Cock
Journal: Annals of the Rheumatic Diseases (2022)

Background Non-pharmacological approaches additional to the pharmacological treatment of rheumatoid arthritis (RA) may include meditation, as well as yoga and mindfulness. These mind-body therapies (MBTs) create an interaction between the mind and body to enhance overall health. MBTs are perceived as valuable in RA management, but the extent of this contribution is unclear, as well as patients subgroups who benefit most from these MBTs. Objectives To investigate the effects of meditation, mindfulness, and yoga in patients with RA in a systematic literature review. Methods A search was performed in 4 databases (PubMed, Embase, Web of Science (core collection, Chinese and Korean collection) and CINAHL). All studies were screened by two independent reviewers, via title/abstract/full text. Studies included any form of meditation, mindfulness and/or yoga as an intervention for patients with RA. Animal studies, case reports, non-English articles, qualitative studies, conference abstracts and articles without full text access were excluded. Each study was assessed for quality. Results Out of the 1,527 records, 23 studies were included after screening (Table 1). There was considerable heterogeneity, both in applied interventions and outcome measurements. All MBTs showed limited beneficial effects on psychosocial outcomes, such as vitality, functioning, and mental health, as well as on disease activity markers. Mindfulness-based interventions mainly reduced the subjective disease activity (e.g., joint tenderness/pain), rather than objective disease activity (e.g., swollen joints/CRP). RA patients with recurrent depression seemed to benefit more from these non-pharmacological therapies than patients without recurrent depression. Table 1. Overview of included studies Author (year) Intervention Country Outcome Author (year) Intervention Country Outcome Yoga Mindfulness Haslock (1994) Yoga UK Functionality Pradhan (2007) MBSR USA QoL, Disease activity, depression Dash (2001) Yoga India physiological Zautra (2008) MERT USA Disease activity, depression, pain Badsha (2009) Yoga UAE Functionality, QoL, Disease activity Davis (2015) MAAT USA depression, anxiety, pain, fatigue Bosch. (2009) Yoga USA Functionality, physiological, depression, pain Fogarty (2015) MBSR New Zealand Disease activity, pain Evans (2010) Iyengar Yoga USA Functionality, QoL, depression, anxiety, pain Dalili (2019) MBCT Iran QoL, depression, anxiety, pain, stress Singh (2011) Yogic package (incl. meditation) India Disease activity, pain Fogarty (2019) MBSR New Zealand Disease activity, depression, anxiety Telles (2011) Yoga India Functionality, Disease activity Relaxation Evans (2013) Iyengar Yoga USA Functionality, QoL, depression, anxiety, pain, fatigue, sleep quality Bagheri-Nesami (2006) Benson Relaxation Iran Disease activity, depression, anxiety, pain, fatigue Ward (2018) Yoga New Zealand Functionality, QoL, Disease activity, depression, anxiety, pain, fatigue, sleep quality Barsky (2010) Relaxation Response (PMR) USA QoL, Disease activity, depression, anxiety, pain, fatigue, sleep quality Greysen (2019) Yoga USA Functionality, depression, pain, fatigue, sleep quality Gautam (2020) Yoga-based lifestyle India QoL, Disease activity, physiological Yazdani (2017) PMR Iran QoL Ganesan (2020) Yoga India Disease activity, physiological Gautam (2021) Yoga India Functionality, Disease activity, physiological Puksic (2021) Yoga Croatia QoL, depression, anxiety, pain, fatigue, stress MBCT = Mindfulness-Based Cognitive Therapy; PMR = Progressive muscle relaxation; MBSR = Mindfulness-based stress reduction, MERT = mindfulness-based emotion regulation therapeutic program, MAAT = mindfulness-based emotion regulation therapeutic program QoL= quality of life Conclusion This systematic literature review found that MBTs have added value in RA management, especially for patients with depressive symptoms. These non-pharmacological approaches as an addition to treatment can be a way to diminish polypharmacy in specific RA patient populations. Disclosure of Interests None declared